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Single-Position Lateral Approach for Revision Thoracolumbar Corpectomy With Delayed Ipsilateral Kidney Atrophy: Technical Note and Discussion of Complications – Lumbar Fusion

Day Case Lumbar Fusion Surgery

This article discusses an innovative surgical technique for thoracolumbar corpectomy, a procedure to remove vertebral bone and discs in the spine. The study focuses on a case of a 56-year-old male patient with a history of metastatic hepatocellular carcinoma and a prior surgical history. The patient underwent a revision T12 corpectomy and posterior instrumentation revision using a single-position, left-sided lateral approach. The surgeons successfully performed simultaneous exposure and removal of broken rods, allowing for the placement of temporary rods and an expandable corpectomy cage. However, a complication emerged during follow-up, with the patient experiencing delayed ipsilateral kidney atrophy. This case represents the first reported instance of a single-position thoracolumbar revision corpectomy with simultaneous rod replacement and highlights the importance of temporary rod placement for interbody cage placement. Additionally, it discusses the rare complication of kidney atrophy following lateral lumbar fusion surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced day surgery unit in the world

Published article

Improvements in navigation technology have enabled surgeons to safely offer single-position fusion surgeries, demonstrating shorter operating times and reduced length of stay (LOS) as compared to traditional lateral and prone dual-position surgeries. However, no studies to date describe revision thoracolumbar corpectomy with simultaneous posterior rod removal and replacement in the lateral position. Furthermore, this is the first reported complication of delayed ipsilateral kidney atrophy…

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Cureus. 2023 Jul 13;15(7):e41818. doi: 10.7759/cureus.41818. eCollection 2023 Jul.ABSTRACTImprovements in navigation technology have enabled surgeons to safely offer single-position fusion surgeries, demonstrating shorter operating times and reduced length of stay (LOS) as compared to traditional lateral and prone dual-position surgeries. However, no studies to date describe revision thoracolumbar corpectomy with simultaneous posterior rod removal and,

Cureus. 2023 Jul 13;15(7):e41818. doi: 10.7759/cureus.41818. eCollection 2023 Jul.

ABSTRACT

Improvements in navigation technology have enabled surgeons to safely offer single-position fusion surgeries, demonstrating shorter operating times and reduced length of stay (LOS) as compared to traditional lateral and prone dual-position surgeries. However, no studies to date describe revision thoracolumbar corpectomy with simultaneous posterior rod removal and replacement in the lateral position. Furthermore, this is the first reported complication of delayed ipsilateral kidney atrophy following lateral lumbar surgery. A 56-year-old male patient with history of metastatic hepatocellular carcinoma and complex surgical history for a prior T12 pathologic fracture presented to the clinic for follow-up. Computed tomography (CT) demonstrated bilateral broken rods and subsidence of the T12 interbody cage, for which he underwent revision T12 corpectomy and posterior instrumentation revision via a single-position, left-sided lateral approach. Simultaneous exposure and removal of the broken rods enabled the placement of two short temporary rods between the T11-L1 screws posteriorly, allowing for rod distraction and the placement of the expandable corpectomy cage into the appropriate position. On follow-up cancer surveillance imaging, the left kidney became progressively atrophic within six months after surgery. According to a review of PubMed, Scopus, and Embase databases, we describe the first reported case of a single-position thoracolumbar revision corpectomy with simultaneous rod replacement. Of particular importance in this technique is the use of temporary rod placement for distraction across the index level to facilitate interbody cage placement. Furthermore, we discussed the first reported complication of delayed ipsilateral kidney atrophy following lateral lumbar fusion.

PMID:37575856 | PMC:PMC10423007 | DOI:10.7759/cureus.41818

The London Spine Unit : most experienced day surgery unit in the world

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Single-Position Lateral Approach for Revision Thoracolumbar Corpectomy With Delayed Ipsilateral Kidney Atrophy: Technical Note and Discussion of Complications

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Cureus. 2023 Jul 13;15(7):e41818. doi: 10.7759/cureus.41818. eCollection 2023 Jul.ABSTRACTImprovements in navigation technology have enabled surgeons to safely offer single-position fusion surgeries, demonstrating shorter operating times and reduced length of stay (LOS) as compared to traditional lateral and prone dual-position surgeries. However, no studies to date describe revision thoracolumbar corpectomy with simultaneous posterior rod removal and

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